Through press coverage, U.S. first ladies have become some of the most prominent and recognized figures in American politics. While the U.S. Constitution doesn't enumerate the responsibilities of the first lady, a succession of dynamic women, beginning with Martha Washington, have shaped this post into a highly visible public office. First ladies have performed a variety of public and private roles, from hostess, escort, and social advocate to advisor and policymaker. The gendered nature of the position, however, has always influenced first ladies' performance as they balanced their institutional duties with high expectations from the press and the public that they serve as role models for American women.

In First Ladies and the Fourth Estate, Burns analyzes the coverage of presidents' wives in five leading newspapers and magazines—The New York Times, The Washington Post, Ladies' Home Journal, Good Housekeeping, and McCall's—to prove that the press has helped shape the first lady institution as well as influence the changing social and political roles of American women. By examining press portrayals of twentieth-century first ladies, Burns highlights the intersection of gender, publicity, and power at particular historical moments. Through the years, journalists have used both the gender ideals of the time and the collective memories of previous first ladies to assess the performance of the president's wife.

The first lady has emerged as a celebrity, an advocate for humanitarian causes, and, in more recent years, a political activist. Burns argues that this evolution of the first lady institution—from the "new woman" of the early 1900s to the "new traditionalist" and "superwoman" of the 1990s, and from the domesticity of the Cold War to the activism of second wave feminism—spurred increasingly critical press coverage as the presidential wives expanded their sphere of influence from the personal to the political. The interdisciplinary approach of this study reveals the significance of the first lady institution not only to women's history and gender studies but also to the study of U.S. history, the American presidency, political communication, rhetorical criticism, and media history.